title: The effect of various vitamin D supplementation regimens in breast cancer patients.
abstract: Vitamin D deficiency in the patients treated for breast cancer is associated with numerous adverse effects (bone loss, arthralgia, and falls). The first aim of this study was to assess vitamin D status, determined by 25-OH vitamin D levels, among women diagnosed with breast cancer according to demographic/clinical variables and bone mineral density (BMD). The second aim of this study was to evaluate the effect of daily low-dose and weekly high-dose vitamin D supplementation on 25-OH vitamin D levels. This retrospective study included 224 women diagnosed with stage 0-III breast cancer who received treatment at the James P. Wilmot Cancer Center at the University of Rochester Medical Center. Total 25-OH vitamin D levels (D(2) + D(3)) were determined at baseline for all participants. Vitamin D deficiency was defined as a 25-OH vitamin D level < 20 ng/ml, insufficiency as 20-31 ng/ml, and sufficiency as ≥32 ng/ml. BMD was assessed during the period between 3 months before and 6 months following the baseline vitamin D assessment. Based on the participants' baseline levels, they received either no supplementation, low-dose supplementation (1,000 IU/day), or high-dose supplementation (≥50,000 IU/week), and 25-OH vitamin D was reassessed in the following 8-16 weeks. Approximately 66.5% had deficient/insufficient vitamin D levels at baseline. Deficiency/insufficiency was more common among non-Caucasians, women with later-stage disease, and those who had previously received radiation therapy (P < 0.05). Breast cancer patients with deficient/insufficient 25-OH vitamin D levels had significantly lower lumbar BMD (P = 0.03). Compared to the no-supplementation group, weekly high-dose supplementation significantly increased 25-OH vitamin D levels, while daily low-dose supplementation did not significantly increase levels. Vitamin D deficiency and insufficiency were common among women with breast cancer and associated with reduced BMD in the spine. Clinicians should carefully consider vitamin D supplementation regimens when treating vitamin D deficiency/insufficiency in breast cancer patients.
authors.affiliation: Department of Radiation Oncology, University of Rochester Medical Center, 601 Elmwood Ave, Box 704, Rochester, NY 14642, USA. luke_peppone@urmc.rochester.edu
authors.forename: Luke J
authors.initials: LJ
authors.lastname: Peppone
authors.forename: Alissa J
authors.initials: AJ
authors.lastname: Huston
authors.forename: Mary E
authors.initials: ME
authors.lastname: Reid
authors.forename: Randy N
authors.initials: RN
authors.lastname: Rosier
authors.forename: Yousef
authors.initials: Y
authors.lastname: Zakharia
authors.forename: Donald L
authors.initials: DL
authors.lastname: Trump
authors.forename: Karen M
authors.initials: KM
authors.lastname: Mustian
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Janelsins
authors.forename: Jason Q
authors.initials: JQ
authors.lastname: Purnell
authors.forename: Gary R
authors.initials: GR
authors.lastname: Morrow
mesh_terms: D000328:Adult; D000368:Aged; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D014807:Vitamin D / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000188:drug therapy / Q000209:etiology
chemical_list: D050071:Bone Density Conservation Agents; D014807:Vitamin D